Abstract Introduction Traditional vasectomy reversals are performed in the operating room under general anesthesia, which poses logistical, financial, and clinical drawbacks. A shift toward office-based vasectomy reversal under local anesthesia may address these limitations. Objective To demonstrate the feasibility and technical approach of performing microsurgical vasovasostomy in an office-based setting using local anesthesia, without compromising patient comfort or surgical technique. Methods In this video we outline a step-by-step microsurgical vasovasostomy in an office-based setting. Results Office-based vasovasostomy is technically feasible in the office-based setting. Conclusions Office-based microsurgical vasovasostomy is safe, feasible, and well tolerated in the office-based setting, offering multiple patient- and provider-centered advantages. Disclosure No